Sonographic Imaging of Extracorporeal Shock Wave Effects in the Liver and Gallbladder of Dogs

Delius, Michael; Gambihler, S.

doi:10.1159/000200939

Cited by 31 publications

(14 citation statements)

References 9 publications

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“…Since bubble diameters cannot be determined by diagnostic ultrasound, their size in vivo is not known. The occurrence of cavitation was associated with signs of damage to liver cells (Forer et al 1992), and tissue damage was observed exactly at the sites where ultrasound signals were picked up (Delius and Gambihler 1992).…”

Section: Cavitation By Tensile Wavesmentioning

confidence: 99%

“…The shock wave entry si!Le was at the bottom. Scale in cm (upper) or inch (lower) (from Delius attd Gambihler 1992) never been severe enough to suggest a substantial loss of renal mass which might hamper renal function. No long-term impairment of renal function has been documented.…”

Section: Shock Wave Action On the Kidneymentioning

confidence: 99%

“…Shock waves can cause a transient increase in membrane permeability without leading to cell death (Gambihler et al 1992). This was shown by entry of a dye which normally cannot enter living cells.…”

Section: Effects At the Snbcellular Levelmentioning

confidence: 99%

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Medical applications and bioeffects of extracorporeal shock waves

Delius¹

1994

Shock Waves

163

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Abstract. Lithotripter shock waves are pressure pulses of microsecond duration with peak pressures of 35-120MPa fotlowed by a tensile wave. They are an established treatment modality for kidney and gallstone disease. Further applications are pancreatic and salivary stones, as well as delayed fracture healing. The latter are either on their way to become established treatments or are currently under investigation. Shock waves generate tissue damage as a side effect which has been extensively investigated in the kidney, the liver, and the gallbladder. The primary adverse effects are local destruction of blood vessels, bleedings, and formation of blood clots in vessels. Investigations on the mechanism of shock wave action revealed that lithotripters generate cavitation both in vitro and in vivo. An increase in tissue damage at higher pulse administration rates, and also at shock wave application with concomitant gas bubble injection suggested that cavitation is a major mechanism of tissue damage. Disturbances of the heart rhythm and excitation of nerves are further biological effects of shock waves; both are probably also mediated by cavitation. On the cellular level, shock waves induce damage to cell organelles; its extent is related to their energy density. They also cause a transient increase in membrane permeability which does not lead to celJ death. Administered either alone or in combination with drugs, shock waves have been shown to delay the growth of small animal tumors and even induce tumor remissions. While the role of cavitation in biological effects is widely accepted, the mechanism of stone fragmentation by shock waves is still controversial. Cavitation is detected around the stone and hyperbaric pressure suppresses fragmentation; yet major cracks are formed early before cavitation bubble collapse is observed. The latter has been regarded as evidence for a direct shock wave effect.

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Section: Cavitation By Tensile Wavesmentioning

confidence: 99%

Section: Shock Wave Action On the Kidneymentioning

confidence: 99%

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Medical applications and bioeffects of extracorporeal shock waves

Delius¹

1994

Shock Waves

163

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“…The explanation was again that damage was caused when gas bubbles were present. The third finding to support the role of cavitation was that tissue damage was observed exactly at the sites where cavitation had occurred and where ultrasound signals had been registered [20].…”

Section: Cavitation and Tissue Damagementioning

confidence: 88%

Twenty Years of Shock Wave Research at the Institute for Surgical Research

Delius¹

2002

Eur Surg Res

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“…A variety of mechanisms could potentially contribute to stone fragmentation, including direct action of stress and cavitation. Cavitation bubbles are almost certainly very important, and have been observed both in vitro and in vivo during lithotripsy (Coleman et al 1987;Kuwahara et al 1989;Coleman et al 1992Coleman et al , 1993Delius & Gambihler 1992;Zhong et al 1997;Cleveland et al 2000). The interaction of shock with cavitation, stone and tissue generates far-field acoustic signals that, it was suggested, could be detected by a passive acoustic device and used as an indicator of the effectiveness of the lithotripter shock in breaking the stone (Coleman et al 1992(Coleman et al , 1993Leighton 1994Leighton , 2004Fedele et al 2004;Bailey et al 2005).…”

Section: Introductionmentioning

confidence: 99%

The collapse of single bubbles and approximation of the far-field acoustic emissions for cavitation induced by shock wave lithotripsy

et al. 2011

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Recent clinical trials have shown the efficacy of a passive acoustic device used during shock wave lithotripsy (SWL) treatment. The device uses the far-field acoustic emissions resulting from the interaction of the therapeutic shock waves with the tissue and kidney stone to diagnose the effectiveness of each shock in contributing to stone fragmentation. This paper details simulations that supported the development of that device by extending computational fluid dynamics (CFD) simulations of the flow and near-field pressures associated with shock-induced bubble collapse to allow estimation of those far-field acoustic emissions. This is a required stage in the development of the device, because current computational resources are not sufficient to simulate the far-field emissions to ranges of O(10 cm) using CFD. Similarly, they are insufficient to cover the duration of the entire cavitation event, and here simulate only the first part of the interaction of the bubble with the lithotripter shock wave in order to demonstrate the methods by which the far-field acoustic emissions resulting from the interaction can be estimated. A free-Lagrange method (FLM) is used to simulate the collapse of initially stable air bubbles in water as a result of their interaction with a planar lithotripter shock. To estimate the far-field acoustic emissions from the interaction, this paper developed two numerical codes using the Kirchhoff and Ffowcs William-Hawkings (FW-H) formulations. When coupled to the FLM code, they can be used to estimate the far-field acoustic emissions of cavitation events. The limitation of the technique is that it assumes that no significant nonlinear acoustic propagation occurs outside the control surface. Methods are outlined for ameliorating this problem if, as here, computational resources cannot compute the flow field to sufficient distance, although for the clinical situation discussed, this limitation is tempered by the effect of tissue absorption, which here is incorporated through the standard derating procedure. This approach allowed identification of the sources of, and explanation of trends seen in, the characteristics of the far-field emissions observed in clinic, to an extent that was sufficient for the development of this clinical device.

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Sonographic Imaging of Extracorporeal Shock Wave Effects in the Liver and Gallbladder of Dogs

Cited by 31 publications

References 9 publications

Medical applications and bioeffects of extracorporeal shock waves

Medical applications and bioeffects of extracorporeal shock waves

Twenty Years of Shock Wave Research at the Institute for Surgical Research

The collapse of single bubbles and approximation of the far-field acoustic emissions for cavitation induced by shock wave lithotripsy

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